Thanks to all authors involved in this thread.  Very informative stuff.

Quote from: mmmmm on June 27, 2016, 01:46:45 PM
various surgeons do such details very differently,

They don't: that's an old hat comment. Variations are minor these days, right around the world, and most good centres are flexible. For instance, PAI will offer different skin graft techniques and are constantly adapting to advances. This is true for most reputable places.

I've written up my report on PAI and Piyavate hospital here: https://www.susans.org/forums/index.php?topic=212657.new;topicseen#new

I have nothing but praise for their professionalism and care.

Can anyone comment how the colon graft option affects the use of penile and scrotal skin use with PAI and how the outcome compares with suporn? (As the differences for standard scrotal graft Pai offer is well established in this thread)


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You can send them an e mail and they will respond..I know that with the colon that infection and problems are more frequent and unless you have minimal scrotal skin then don't do it .

Quote from: warlockmaker on August 08, 2016, 08:24:54 AM
You can send them an e mail and they will respond..I know that with the colon that infection and problems are more frequent and unless you have minimal scrotal skin then don't do it .

Ok, thanks. What confused me was the advertising on their site for increased depth. Wasn't sure if the rest of the skin  would be used differently. Appreciated


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One thing that I really noticed at PAI is that they're flexible. They state this explicitly now in terms of their surgery, no longer describing a singular technique. This relates in part to the fact that they have a team of top surgeons and also to what Warlockmaker described elsewhere: that as the paying client you can push for what you want. I have little doubt, for instance, that if you wanted an emphasis on as realistic a fourchette as possible they would deliver. Concretely I know they will consider various graft techniques if required.

One of the few peer-reviewed academic studies on Thailand GRS notes the way in which techniques at PAI have evolved: 'The surgical technique for vaginoplasty and clitoro-labioplasty used at the Chulalongkorn University and at the PAI in Bangkok is the evolution of several refinements implemented to the original inversion peno-scrotal technique'

1975 Primitive inverted peno-scrotal flap
1983 Posterior urethral flap (To prevent urethra stenosis and to give some mucosa tissue to vaginal introitus)
1990 Total resection of the corpus spongiosum (To allow penetration without swelling during sexual arousal)
1999 Surgicel onto urethra clitoris (To prevent bleeding)
2000 Bottoming out suture on the top of clitoris (Appearance of the clitoral body)
2003 Prepucial skin (Reconstruction of the clitoral hood)
2003 M-shaped glans flap (Shaping of the clitoris)
2005 Perineal stitch to fix the scrotal flap to the rectal wall (Prevention of (minor) scrotal flap prolapse)

'Preecha's team refinements consist of: (1) cavity dissection with blunt technique; (2) the use of skin graft in addition to the penile flap; (3) shaping of the clitoris with abundant prepucial foreskin; and (4) urethra mucosa to line the anterior fourchette.'

'In the period 1975–2013, Preecha's group (Bangkok, Thailand) performed nearly 3000 vaginoplasties in male-to-female transsexuals.
In the present manuscript we describe in details the surgical technique currently in use by the same group (Chulalongkorn University and "Preecha Aesthetic Institute" (PAI), Bangkok). Preecha's technique is comprised of several surgical refinements added during the past 39 years of practice by Dr Preecha and his team colleagues.'

'With the refinements introduced, it has been possible to achieve a result that is very close to the biological female genitalia.'

I cannot link to the full article as it contains graphic pictures of the operation. However, the safe abstract can be seen here: http://www.ncbi.nlm.nih.gov/pubmed/25356769

Hi Richenda, did you happen to find out how many SRS the individual surgeons have each done?Dr Preecha's team has presumably evolved significantly evolved over the years since he's taught most of the SRS surgeons in Thailand.

That's a very good question. No is the straight answer, but it's one I should probably ask (and will do). Warlockmaker may know more. I know that Drs Burin and Sutin now do most of the GRS but the team is quite large: at least six surgeons with different specialisms. For instance, Dr Sirichai does some of the FFS work.

I'll try and find out the answer as it's a pretty important question.

Quote from: AnonyMs on August 11, 2016, 01:03:00 AM
Hi Richenda, did you happen to find out how many SRS the individual surgeons have each done?Dr Preecha's team has presumably evolved significantly evolved over the years since he's taught most of the SRS surgeons in Thailand.

Email I got back from pai the other night when asked bout the colovaginaplasty

"Your letters are perfect for surgery.

Dr.Sutin has been perform Sigmoid Colon around 128 cases a year since 2002.
Dr.Sutin has been perform Penile Skin Inversion around 153 cases a year
since 2001."
Another question that always got me is why so many on here prefer chett (at least on here ). It's so rare to come across a pai review


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Heya.. Well its been interesting reading about the PAI...  Discovered a heap of new information.. I am so glad the PAI is coming across as a credible clinic.. I really like their approach to money. They have not pressured me for any money and they have not made any reference to paying them. I like the idea of only $300 deposits as mentioned at this post, since something might happen. I think I am making all the right choices in choosing the PTI..  Its needs to be since I have my consolation on the 4th January and if all goes well.. snip snip after that.. One full year ahead of schedule.. I am in Thailand in January anyway when I suddenly realised, hey why not get it done.... So, I am!!

Quote from: TinaVane on August 11, 2016, 02:16:38 AM

Another question that always got me is why so many on here prefer chett (at least on here ). It's so rare to come across a pai review

Here's a theory about that. We all tend to want to praise the person who changes our life. It's totally understandable. Chet and Suporn are essentially one-man shows and so it's easier for them to have a one-man cult status. PAI, especially since Dr Preecha delegated the work to his trained surgeons because of his advancing years, operates much more as a team. There are half a dozen top surgeons performing.

My own views are by now well known but I gain nothing personally from praising PAI. I've just been massively impressed by them, and their handling of my surgery was exemplary. Tess, I think you're making a well informed and excellent choice. They have been brilliant. I have nothing but praise for them based on my experience and won't go anywhere else for the remainder of my work.

Quote from: TinaVane on August 11, 2016, 02:16:38 AM
Dr.Sutin has been perform Sigmoid Colon around 128 cases a year since 2002.
Dr.Sutin has been perform Penile Skin Inversion around 153 cases a year
since 2001."
Another question that always got me is why so many on here prefer chett (at least on here ). It's so rare to come across a pai review

Those are impressive numbers, and interesting for several reasons. Why so many colon SRS, when you hardy hear about it and its usually to be the choice when normal SRS needs fixing? It is rare to hear anything about PAI; I'd guess they have lots of patients from non-English speaking countries so they are less visible to use English speakers, but Dr Chett appears significantly more talked about than Suporn and I've no idea why that is. I'd have thought they attact the same demographic.

Quote from: Richenda on August 11, 2016, 07:29:48 PM
Here's a theory about that. We all tend to want to praise the person who changes our life. It's totally understandable. Chet and Suporn are essentially one-man shows and so it's easier for them to have a one-man cult status. PAI, especially since Dr Preecha delegated the work to his trained surgeons because of his advancing years, operates much more as a team. There are half a dozen top surgeons performing.

My theory (not having been there) is that even though Dr Preecha no longer does surgery he has set the general culture PAI, so the standard of care you have would likely be of consistent (high) quality no matter who did the surgery. It sounds like he's picky who he works with as well, so you get good surgeons there as well.

I don't know much about Dr Chett so I can't comment, but I believe Suporn to be an unusually talented surgeon and that's what you get when you see him. There's only one of him, and he does his thing(s) and nothing else, so its kind of a take it or leave it deal. For what its worth he trained under Preecha, though what that means I don't know.

Personally I'd go to Suporn for SRS, but PAI do some other procedures I'm interested in. I'm really impressed by all I've read and I'll consider them very seriously in due time. I'm pretty sure I'd choose PAI for an orchi if I were to do that.

Hey.. I am on Count Down with the PAI.. Booked in for my SRS on 6th Jan.. Started HRT on the 7th October.. No bad or good side effects so far.. Very early days.. Feel really good to be honest.. After following Carrie Liz journey I feel I know some of what to expect.. I am certain I have made all the right choices. The PAI is mid priced and very experienced surgeons.

With HRT I am on Patches.. My Gender doctor told me that injections can cause blood cloths and pills can put the liver under stress and more.. I could have had the cream gel but I opted for the patches.. Easy to apply every other day.. and very cheap. I am luck in Australia.. To see my Gender doctor cost me nothing and he is just wonderful, very very supportive.. The patches for 11 cost $5.30.. He has given me a letter to have F placed on my passport and medicare card.. As soon as I have a few docs to show I am F, I can apply for a new birth certificate with my chosen female name and then update all documents accordingly.. Nothing is hard to do.. Heaps easier than I was expecting to be honest.. But it was not always the case..

I was bashed in the UK many years ago almost to death, but I did not expect that to be apparent in Australia.. After viewing a TV show a few days ago, it seem not only Gays and Lesbians were bashed, some were killed and their bodies never found.. Just terrible.. Thankfully we have all moved on from those horrible times.. I feel that those responsible for those terrible acts live in fear in cause the bodies are ever found and that DNA would lead to them..

When we moved to England from Africa after my old dad left the British army, my dad took me to see a psychiatrist. I was diagnosed with Gender Dysphoria but he told no one since it was illegal to be gay or lesbian in the UK at that time.. So many stupid laws have effected the lives of so many really nice people. Thankfully attitudes have come a long way since those dark days...

I will let you all know how I go with my SRS.. I might start a new post...

Apart from the awful suffering and violence in the past that you describe that's a wonderful post to read Tess. Many congratulations on starting the HRT and the incredibly exciting news about your surgery. We might just get to overlap as I'm out there in December for FFS but it depends if I extend my stay. Do you know which of the PAI team will be operating (not that it matters as they are all brilliant).

Please be sure to keep us posted?!

yours,

Rach x

Hi Rach.

If it wasn't for the fact that I saw a psychologist I would have hoped to have forgotten past happenings.. For that reason I stopped going since it was far to upsetting... My Gender Doctor said I will need see one in time when my emotions cause issues but I am hopeful I can keep them under control.. He has recommend a better psychologies just in case. I really like to look forward and not back.. If the psychologies asks me about my past I think I might just skirt around it.. I really do not see any reason to bring it all up.. I had to mention in part to my Gender Doctor but he has never pushed me for any details. I am so lucky to be seeing him..

I was hoping that Dr. Burin was going to do my SRS but he is on leave.. So Dr.Sutin will be doing it..

I look forward to hearing about your FFS journey since I too will be thinking of having FFS surgery probably with the PAI late next year.... I still need to work so I will do it slowly.. I was going to have the Tracheal Shave surgery at the same time as my SRS but its way expensive.. Double the price as getting it done at MDM, by Dr. DiMaggio..

I will ask when I am there how much and what they can do for me in regards to FFS... I feel in a year the HRT might show signs of effecting my appearance so it might be a good time to get some FFS done then.. Wait for it to heal and perhaps get more as I go and can afford to.. I sure wish I did all this years ago but its just bad timing.. To be born in todays society, its just so much easier, partially in Australia... Good for them.. If I had the money I would get it all done ASAP and give up work, live a happy life in my own skin..  but... I need to pay my way for a few more years yet..

Hi Tess, I had my ffs, ba and srs with 3 surgeons from Pai at one go. Dr Sutin did my srs I was thrilled with the result, great aesthetics and have since had wonferful orgasms both at the clitoris and in the vagina. My Ffs was done by Dr Sirichai and he wad also fantastic, my scars are not even  visible now 8 months later. My ba was done by my friend Dr Pteecha and that was also magnificent. I now live in Bangkok and love it here. Contact me if you come here.

Tess, I've met ^^^ ^^^  Warlockmaker ^^^ ^^^ in the flesh and she's fabulous: the most beautiful lady who transitioned that I've seen. You are going to be in the hands of a very fine and skilled surgeon. Dr Sutin performed my bilateral orchiectomy in July and he's doing my FFS at the beginning of December. Dr Sutin is also a sweetie. Dr Preecha has built a superb team at PAI, so please take encouragement from Warlockmaker's post

I guess you're probably right about the HRT having an effect on your face. My GiC consultant said the same thing to me but I have been self-medicating for 2 years, admittedly with a couple of interruptions, so the changes from HRT are most likely in place now. I'm going to be having brow lift with hair advance, orbital rim shave, nose alarplasty and tipplasty and a full facial lift. Well, as long as I can rub together all the money in time Flight is booked for 28/11 and surgery on 2/12. It's possible I will extend a stay in SE Asia. I love Bangkok: it's a wonderful city but I also quite fancy Christmas in Bali. So if I do it'll be great to meet up. I don't know if I'd advise you to wait for FFS. Personally I'd go for it but that's not in any sense a medically informed comment!

x

Thats sounds wonderful.. I am so happy to read you comments.. I was so worried but I think I have chosen wisely with the PTI.. I have had very good communication and my questions have been answered quite quickly.. I have never been pestered for money although I am expecting that I will be asked for a deposit next month... They will pick me up from the airport.. and take me back at the right time.. I am so excited about it I am busting.. Its all been a long time in coming. Nothing is cheap but thankfully Thailand is heaps cheaper than Australia and they have heaps better skills too.. I will have the doctors check my face out and hopefully they can provide some options for me... I really do not know how I can afford to have it done.. Even in Thailand its expensive.. I bought a new wig which looks awesome, very similar to my pic here.  I really do not want to get upset that my face has little femininity since I was a lot younger when people thought I as a girl.. I have suffered from Testosterone poisoning for far too long so consequently it has done its even dead on me..   I have to be positive and I do.  I am on HRT at long last and I feel wonderful about it.. I am due to have my SRS done and I am busying with happiness about it..  I do not worry about boobs, I think they will grow a bit more without surgery.. But they will be the last thing to achieve..

Thank you for posting...

Quote from: warlockmaker on October 21, 2016, 05:44:27 AM
Hi Tess, I had my ffs, ba and srs with 3 surgeons from Pai at one go. Dr Sutin did my srs I was thrilled with the result, great aesthetics and have since had wonferful orgasms both at the clitoris and in the vagina. My Ffs was done by Dr Sirichai and he wad also fantastic, my scars are not even  visible now 8 months later. My ba was done by my friend Dr Pteecha and that was also magnificent. I now live in Bangkok and love it here. Contact me if you come here.

Hi Rach.. I really do look forward to hearing about your results.. I would also love to meet up with other ladies but.. BUT.. I am not happy for anyone to see me as I am.. I am a male looking transgender.. I really cannot be accepted as a female in public which really saddens me.. I need to have some extensive FFS before I see anyone .. I want to be an extroverted female full of confidence in my own skin.. Thankfully, my body is good for nearly 60, far better than many CIS women to be honest. We all come in different shapes but my face is a dead give away. I dream that one day I will have the $$ to change my life.. But for now I am very happy to be on HRT and getting my SRS done.. I think I feel at least 10 years younger even thinking about it.. Ashley on the forum posted some of her before and after pics. She is my mentor, my hero. She has impaired me that anything is possible. She is always happy and only just married. She is my bestest friend who guilds me and provides positive thoughts. One day, I will be as beautiful has her and on that day I will be the women I was always meant to be..

I am due to stick another patch on later tonight.. YAY!!!